Healing and Recurrence Rates Following Ultrasound-guided Foam Sclerotherapy of Superficial Venous Reflux in Patients with Chronic Venous Ulceration

• Published in: European journal of vascular and endovascular surgery Vol. 40; no. 6; pp. 790 - 795
• Main Authors: Pang, K.H, Bate, G.R, Darvall, K.A.L, Adam, D.J, Bradbury, A.W
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.12.2010
• Subjects: Aged; Chronic Disease; Chronic venous ulcers; Databases as Topic; England; Female; Healing rates; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Prospective Studies; Recurrence; Recurrence rates; Sclerosing Solutions - therapeutic use; Sclerotherapy; Surgery; Time Factors; Treatment Outcome; Ultrasonography, Interventional; Ultrasound-guided foam sclerotherapy; Varicose Ulcer - diagnostic imaging; Varicose Ulcer - pathology; Varicose Ulcer - therapy; Venous Insufficiency - diagnostic imaging; Venous Insufficiency - pathology; Venous Insufficiency - therapy; Wound Healing; Healing rates; Chronic venous ulcers; Recurrence rates; Ultrasound-guided foam sclerotherapy
• ISSN: 1078-5884; 1532-2165
• DOI: 10.1016/j.ejvs.2010.08.011

Abstract Objectives To determine healing and recurrence rates following ultrasound-guided foam sclerotherapy (UGFS) of superficial venous reflux (SVR) in patients with healed (clinical, etiologic, anatomic and pathophysiologic (CEAP) classification, C5) and open (C6) chronic venous ulceration (CVU). Methods Between 1 March 2005 and 31 December 2009, 130 consecutive patients (132 limbs, 49 CEAP C5, 83 C6) of median age 70 (interquartile range (IQR) 56–76) years underwent UGFS as part of their treatment for CVU. Results The median (IQR) follow-up time was 16 (12–32) months. One C6 patient moved abroad 1 week after UGFS and was lost to follow-up. Healing was observed in 67/82 (82%) remaining C6 patients at a median (IQR) of 1 (1–2) month following their first UGFS treatment. In 49 limbs originally treated for C5 disease, and in 67 limbs treated for C6 that healed following UGFS, there were five recurrent ulcers during the follow-up period, giving a 4.9% Kaplan–Meier estimate of recurrence at 2 years. In legs treated for C6 and C5 disease, the median (IQR) ulcer-free periods were 22 (IQR 9–32) and 14 (IQR 8–36) months, respectively. Discussion Healing rates following UGFS for CVU are comparable to those reported after surgery but recurrence may be lower. UGFS is a safe, clinically effective and, thus, highly attractive minimally invasive alternative to surgery in patients with C5 and C6 disease.